Opioid Protective Behavioral Strategies Scale (OPBSS)

Description

The Opioid Protective Behavioral Strategies Scale (OPBSS; Hurlocker & Pearson, 2025) is designed to evaluate the extent to which individuals who use licit and/or illicit opioids employ protective behavioral strategies (PBS). Recognizing the existing validated measures for alcohol- and cannabis-specific PBS use, Hurlocker and Pearson sought to develop and validate an opioid-specific PBS measure. The initial scale consisted of 60 items, developed through adapting items from existing alcohol and cannabis PBS measures and reviewing literature on opioid harm reduction. The initial OPBSS was administered online to adults in the U.S. who reported opioid use in the past month. Through item and exploratory factor analyses, 14 items were removed, resulting in a 46-item scale. The analyses supported a two-factor structure.

Purpose

The primary purpose of the OPBSS is to assess behaviors that individuals can utilize before, during, after, or instead of opioid use with the aim of preventing risky opioid use.

Instrument

• Test Type: Original

• Format: Items are rated using six response options.

• Language Available: English

• Population Group: Human; Male; Female

• Age Group: Adulthood (18 yrs & older)

• Population Details: The OPBSS was administered to adults in the United States who reported using opioids.

• Test Methodology: Test Validity; Concurrent Validity; Convergent Validity; Criterion Validity; Predictive Validity; Test Reliability; Internal Consistency; Test-Retest Reliability; Factor Analysis; Exploratory Factor Analysis

Reliability

The OPBSS subscales demonstrated high internal consistency. Test-retest reliability was supported after 1 month (.40 < ICCs < .64), except for two items (Items 6 and 37) that demonstrated poor reliability.

Validity

Criterion-related validity was demonstrated through significant differences in opioid-related characteristics on the OPBSS factors based on ANOVAs. Specifically, there was a main effect of opioid type on Controlled Opioid Use (COU), F(3, 323) 4.13, p= .007, and Serious Harm Reduction (SHR), F(3, 322)= 6.08, p< .001. There was also a main effect of route of administration on COU, F(2, 278) = 9.94, p < .001, and SHR, F(2, 277) = 36.77, p <.001. Concurrent and predictive validity were partially supported. OPBSS subscale scores were associated with at-risk opioid use, △F (2, 190) = 23.97, △R2 < p .001 = .146, and opioid-related consequences △F( (2, 243) = △R2 12.49, < p .001, = .063, at Time 1. Convergent validity was supported by positive correlations between the OPBSS factors and alcohol and cannabis PBS, and negative correlations with opioid-related outcomes at both time points.

Factor Analysis

Exploratory factor analysis (EFA) initially suggested a two-factor solution based on parallel analysis and SRMR (.043), but six items were removed due to near-equivalent cross-loadings. After re-estimation with the remaining 47 items, a two-factor solution was supported (SRMR = .040). One additional item was removed due to a factor loading below .40. The final EFA with the remaining 46 items supported a two-factor solution (SRMR = .040).

Permissions & Fee and Test Year

• Commercial: No

• Fee: No

• Permissions: May use for Research/Teaching

• Test Year: 2025

Authors

• Hurlocker, Margo C.

  • Author ORCID Identifier: http://orcid.org/0000-0002-9744-8551

  • Affiliation: Center on Alcohol, Substance Use, and Addictions, University of New Mexico

  • Email: [email protected]

  • Correspondence Address: University of New Mexico, Center on Alcohol, Substance Use, and Addictions, 2650 Yale Boulevard Southeast, MSC11 6280, Albuquerque, New Mexico, United States, 87106, [email protected]

• Pearson, Matthew R.

  • Affiliation: Center on Alcohol, Substance Use, and Addictions, University of New Mexico

• Email: No data is Available

• files No file is available

Keywords

Controlled Opioid Use; Serious Harm Reduction; Protective Behavioral Strategies; Opioids; Harm Reduction; Substance Use and Addiction Measures; Opioid Analgesics; Protective Behavioral Strategies

Reference’s

Hurlocker, M. C., & Pearson, M. R. (2025). Opioid Protective Behavioral Strategies Scale (OPBSS): Development and psychometric evaluation. Experimental and Clinical Psychopharmacology, 33(1), 100–108. https://doi.org/10.1037/pha0000738

Items of the Opioid Protective Behavioral Strategies Scale (OPBSS)

This measure consists of 46 items. The specific items are available in Table 2, Pages 104-105 of the source document (2025-17774-001).

• Factors and Subscales: Controlled Opioid Use (COU); Serious Harm Reduction (SHR).

Instructions: Please indicate how often you have used each of the following strategies in the past 30 days. Use the following scale:

1 = Never
2 = Rarely
3 = Occasionally
4 = Sometimes
5 = Usually
6 = Always

Controlled Opioid Use

In the past 30 days, how often have you…

1. Only used opioids after completing all of the day’s responsibilities?

2. Avoided using while spending time with family?

3. Avoided using opioids before work or school?

4. Avoided using opioids to cope with emotions such as sadness or depression?

5. Used a designated driver (i.e., someone who has not used) after using opioids?

6. Limited use to weekends?

7. Avoided using opioids habitually (i.e., every day or multiple times a week)?

8. Avoided using opioids early in the day?

9. Avoided using opioids for several days in advance of a big test, interview, performance, or other engagement for which you needed to be crisp and were being evaluated?

10. Avoided buying opioids?

11. Avoided using opioids if currently taking any kind of prescription drug that might intensify the effects (e.g., make them feel more tired)?

12. Only used at night (i.e., not during the day)?

13. Stopped using opioids if you became anxious or paranoid?

14. Avoided using opioids in public places?

15. Taken periodic breaks if it felt like you were using opioids too frequently?

16. Bought less opioids at a time so you used less?

17. Excused yourself from the room if people were using opioids and you felt uncomfortable or did not wish to be offered opioids?

18. Avoided situations that you anticipated being pressured to use opioids?

19. Taken a break from using if feeling a loss of motivation?

20. Only used when you had nothing important to do for the rest of the day/night?

21. Avoided using opioids out of boredom?

22. Only used one time during a day/night?

23. Avoided using when feeling anxious (e.g., using to calm yourself down or stop worrying)?

24. Only used before special events (e.g., movies, concerts) or on special occasions?

25. To decrease tolerance, taken a break for a week or two, or taken longer breaks than usual between use?

26. Avoided using opioids before engaging in physical activity (i.e., exercise, hiking)?

27. Had a friend let you know when you’ve had enough?

28. Made sure that you went home with a friend?

29. Refused to ride in a car with someone who has been using opioids?

30. Had your drugs tested for fentanyl?

31. Avoided using opioids to manage pain?

Serious Harm Reduction

In the past 30 days, how often have you…

1. Avoided mixing opioids with alcohol?

2. Avoided bringing opioids into events or venues where you were likely to be searched?

3. Only purchased opioids from a trusted source?

4. Used only at home?

5. Avoided possibilities of legal repercussions (e.g., used in a safe place like home, avoided having opioids where you might get searched)?

6. Only used opioids on private property?

7. Limited the amount/dose of opioids you used in one sitting?

8. If attending a party or going out to a social event (e.g., bar), decided in advance whether you wanted to use opioids or not?

9. Used your own opioids (if alone or sharing with friends) so you knew what you were using?

10. Only used opioids in safe environments?

11. Determined not to exceed a set amount/dose of opioids?

12. Avoided combining opioids with benzodiazepines (like Valium, Xanax, Ativan, Klonopin, etc.)?

13. Avoided combining opioids with cocaine (i.e., speedballing)?

14. Made sure you used opioids with people who could take care of you if you used too much?

15. Avoided using injectable opioids?